AB0696 EULAR SJOGREN’S SYNDROME PATIENT REPORTED INDEX (ESSPRI) AND OTHER PATIENT-REPORTED OUTCOMES IN ASSESSMENT OF GLANDULAR DYSFUNCTION IN SJÖGREN’S SYNDROME
Authors: E. J. Nam, H. Ture, S. J. Lee, N. R. Kim
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> Sjögren's syndrome (SS) constitutes a common autoimmune disease in which the exocrine glands, especially salivary and lacrimal glands, produce excessive immune responses with the resultant tissue damage leading to mucosal dryness. For assessment of disease activity, the EULAR Sjögren's Syndrome Disease Activity Index (ESSDAI), ESSPRI, and other patient-reported outcomes (PROs), such as visual analog scale (VAS) for symptoms, and EULAR sicca score (ESS), are performed. ESSPRI, ocular staining score (OSS), salivary flow rate (SFR), salivary gland scintigraphy (SGS), and minor salivary gland (MSG) pathology have a cooperative relationship with regard to the evaluation of glandular function and inflammation in SS, its diagnosis and therapeutic management, and patient follow-up. However, although ESSPRI is reported to show a significant correlation with PROs, the relationship between ESSPRI or RPOs and objective parameters of glandular dysfunction, especially salivary and ocular glands, is not well defined. <h3>Objectives</h3> To investigate whether ESSPRI or other PROs are correlated with objective parameters of glandular dysfunction in primary SS (pSS). <h3>Methods</h3> A total of 70 patients with pSS were included in the present study. Disease activity indexes including ESSPRI, EULAR sicca score (ESS), VAS scores for symptoms, and ESSDAI, serologic markers, SFRs, SGS, MSG biopsy, and OSS were evaluated. Correlations were calculated with the Spearman correlation coefficient. <h3>Results</h3> ESSPRI was a significantly correlated with its domains (dryness domain, r=0.661 p&lt;0.001; fatigue domain, r=0.859, p&lt;0.001; pain domain, r=0.849, p&lt;0.001). ESSPRI showed a significant correlation with ESS (r=0.639, p&lt;0.001), oral (r=0.522, p&lt;0.001) and ocular dryness VAS (r=0.482, p&lt;0.001), acute phase reactant levels (ESR, r=0.271, p=0.028; CRP, r=0.322, p=0.008), serum IgG level (r=0.322. p=0.033), and ESSDAI (r=0.371, p=0.002), while it was not correlated with SFRs, data of SGS, focus score (FS) and OSS. ESSPRI dryness domain was significantly correlated with ESS (r=0.969, p&lt;0.001), SFRs (unstimulated, r=-0.281 p=0.025; stimulated, r=-0.263, p=0.037), data of SGS (parotid gland [PG] uptake ratio [UR], r=-0.252, p=0.044; submandibular gland (SMG) UR, r=-0.357, p=0.004; SMG ejection fraction [EF], r=-0.325, p=0.009), FS (r=0.261, p=0.050) and OSS (r=0.386, p=0.002). However, it did not demonstrate the correlation with ESSDAI, acute phase reactant levels, and serum IgG level. ESS was closely correlated with SFRs (unstimulated, r=-0.400, p=0.001; stimulated, r=-0.364, p=0.003), data of SGS (PG UR, r=-0.325, p=0.009; PG EF, r=-0.285, p=0.023; SMG UR, r=-0.424, p&lt;0.001; SMG EF, r=-0.356, p=0.004), FS (r=0.284, p=0.032), and OSS (r=0.340, p=0.007), but not with ESSDAI, acute phase reactant levels, and serum IgG level. Oral dryness VAS was also correlated with SFRs (unstimulated, r=-0.527, p&lt;0.001; stimulated, r=-0.470, p&lt;0.001), data of SGS (PG UR, r=-0.417, p=0.001; PG EF, r=-0.366, p=0.003; SMG UR, r=-0.467, p&lt;0.001; SMG EF, r=-0.377, p=0.002), and FS (r=0.288, p=0.030) but not with OSS. Ocular dryness VAS showed a significant correlation with OSS (r=0.422, p=0.001), but not with parameters of salivary gland dysfunction. <h3>Conclusion</h3> The present study demonstrated that ESSPRI dryness domain, ESS, and VAS for symptoms, but not ESSPRI, reflected the glandular dysfunction in SS. <h3>References</h3> [1]Seror R, Theander E, Brun JG, et al. Validation of EULAR primary Sjogren's syndrome disease activity (ESSDAI) and patient indexes (ESSPRI). Ann Rheum Dis 2015;74:859;66. [2]Cho HJ, Yoo JJ, Yun CY, et al. The EULAR Sjogren's syndrome patient reported index as an independent determinant of health-related quality of life in primary Sjogren's syndrome patients: in comparison with non-Sjogren's sicca patients. Rheumatology (Oxford) 2013;52:2208;17. <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> None Declared.